Eliquis and Food Interactions

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS

 

Everything in nature interacts.

Often these interactions are harmless or even beneficial. When they aren’t helpful, we tend to avoid them. However, with modern medicine, interactions are sometimes unavoidable as doctors try to balance the good and the bad.

Eliquis is a blood thinner and follows the same patterns as other medicines.

If you or a loved one takes Eliquis, ensure you know what to avoid to prevent adverse reactions.

What is Eliquis?

Eliquis is the brand name for Apixaban and is a blood thinner used to prevent blood clots.

It is explicitly used with atrial fibrillation patients to help prevent strokes, deep vein thrombosis, and pulmonary embolism.

It’s very common for patients who are having joint replacement surgery.

Furthermore, it is generally prescribed for 2-5 weeks after surgery, depending on the type and intensity of the surgery.

Doctors recommend taking the medication around the same time every day. This helps maintain an average amount of the medication at all times.

Eliquis does not need to be taken with food. It may be helpful to take it with something if you have trouble swallowing pills.

Edible Interactions

The good news is there are no major negative digestive interactions to be worried about while taking Eliquis. However, this doesn’t mean you shouldn’t be careful about what you’re putting into your body while on this medication.

Food

Several foods should be limited while on Eliquis, since they can somewhat counteract the drug’s effects.

Grapefruit is at the top of this list.

Like the other foods we’ll hit on this list, grapefruit acts as a moderate inhibitor of CYP3A4 and can increase the potency of blood thinners.

According to the literature, there is no real risk for complications in moderate doses. However, avoiding binge-eating a crate of grapefruits is probably best while you are on Eliquis.

If grapefruit is a regular part of your diet, your body should be able to adjust to the new medication.

If you have questions about grapefruits or grapefruit juice, the best bet is to check with your doctor. They will know you and be able to make a judgment call on how to proceed.

Herbal Supplements

While the list of foods is limited to one thing, there is a slightly longer list of herbal supplements that doctors may ask you to avoid.

  • Ginger
  • Ginkgo Biloba
  • Turmeric
  • White Willow
  • St. John’s Wort

There is less literature on these supplements, but the gist of the information is that they can promote blood clotting in the body, which goes counter to the blood thinning intent of the Eliquis.

In smaller amounts, such as cooking, the herbs are perfectly safe, but when they are taken in higher amounts, i.e., capsule form, they can introduce enough of the herb to cause an issue.

At the end of the day, the best course of action is to run stuff by your doctor. They will know best how your daily routines will interact with any medication.

Alcohol

Eliquis works so well compared to other blood thinners like warfarin or rivaroxaban because it isn’t a whole-body inhibitor.

Instead, Eliquis works with liver enzymes to block clotting factor Xa to help limit the body’s natural clotting ability.

By working with the liver, Eliquis limits patients’ negative interactions with food and other blood thinners.

One universal thing is alcohol consumption.

Whether you’re taking a traditional blood thinner or Eliquis, consuming alcohol to any excess interferes with the body’s ability to moderate blood clotting.

For Eliquis, since it interacts with the liver, alcohol can hinder the medication’s effectiveness.

While alcohol will not directly interact with Eliquis in the liver, it naturally interferes with the body’s ability to form blood clots.

Excessive drinking can lead to bleeding problems that are compounded by taking Eliquis.

Potential Substitutes

The key here is moderation.

When looking at any of the potential interactions we’ve talked about above, none of them are immediately life-threatening. Most of the interactions are, and have been, under medical review for years.

This means there is very little likelihood of severe interactions between Eliquis and any food, drink, or herbal supplement.

You are much more likely to find a negative interaction with another drug.

That means searching for a substitute is generally unnecessary.

When you can talk to your doctor and perhaps limit the amount of grapefruit, you don’t have much to worry about. The same goes for alcohol.

Limiting your intake is more manageable than finding an actual substitute.

However, try oranges if you are set on finding something to substitute for grapefruit. It remains in the citrus family and can give you a similar sweet and tart flavor.

Other fruits such as mangos or pineapple can be great breakfast options.

You may be changing your lifestyle and want to reduce your alcohol consumption. In that case, this is a great time to make it happen.

Coupling that lifestyle change with joint replacement surgery can be very beneficial on multiple fronts.

Some easy replacements for alcohol are seltzers, unsweetened iced tea, and virgin versions of your favorite drink.

By swapping out drinks, you can avoid putting excess stress on your liver while taking a medication that functions primarily in your liver, and you can also lower the potential for excessive bleeding should you cut yourself.

The Wrap

Eliquis is more commonly prescribed now because of the limited number of negative interactions with foods and other drugs.

As we said above, even the limited adverse reactions are not fully proven.

Researchers and doctors are testing to see if there is a measurable reaction between Eliquis and grapefruit, blood-thinning herbal supplements, and alcohol.

The most significant problem is amplified blood thinning when Eliquis is combined with the discussed items.

The best option is to talk to your primary care physician. They’re the ones who will know you the best and will be able to determine if your lifestyle could prove any sort of problem to a drug.

For further information, contact us and see how we can help you with your medication. We have plans to help you get the services you need at a price that fits your bank account.

At The Rx Advocates, we’re here to help you find the right answers.

  1. MedlinePlus. Apixaban. June 2020. Available at medlineplus.gov.
  2. The Mayo Clinic. Apixaban (Oral Route). November 2022. Available at mayoclinic.org.
  3. The Skeptical Cardiologist. Is it Safe To Consume Grapefruit If You Take The Blood Thinner Apixaban (Eliquis)? July 2018. Available at theskepitcalcardiologist.com.
  4. Institute for Safe Medication Practices. Eliquis (Apixaban). Available at ismp.org.
  5. University of Washington Medical Center. Treatment with Apixaban (Eliquis). October 1013. Available at depts.washington.edu.
  6. National Health Services. Common questions about Apixaban. May 2020. Available at nhs.uk.
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